Table 4.

Possible criterion addition to the ACR (2010) diagnostic criteria and the modified ACR survey criteria (2011) for FM.

VariableACR (2010)Modified ACR (2011)Possible Criterion Addition for 2010/2011 Criteria
CriteriaWPI 3–6 and SSS ≥ 9, or WPI ≥ 7 and SSS ≥ 5WPI 3–6 and SSS ≥ 9, or WPI ≥ 7 and SSS ≥ 5
Assessment methodPhysician assessmentPatient self-report
Symptoms assessed, 0–12Fatigue, 0–3Fatigue, 0–3
Sleep disturbance, 0–3Sleep disturbance, 0–3
Cognitive problems, 0–3Cognitive problems, 0–3
Somatic symptom reporting, 0–3Abdominal pain, 0–1, headache, 0–1, depression, 0–1
WPI, 0–1919 sites19 sites
WS pain regions, 0–55 regions
≤ 1Not usedNot usedExcludes FM
2Not usedNot usedExcludes FM
3Not usedNot usedExcludes FM
4 or 5Not usedNot usedRequired for FM
  • The 5 WS pain regions are derived from sites specified in the WPI. The axial region includes the neck, upper back, and lower back. The upper regions (left and right) include the shoulder girdle, upper arm, and lower arm. The lower regions (left and right) include hip (buttock, trochanter), upper leg, and lower leg. The WPI does not include the wrist, ankle, and foot. The jaw, chest, and abdomen are not included in the 5-region definition. The number of regions with pain is the sum of axial, left upper, right upper, left lower, and right lower regions. ACR: American College of Rheumatology; FM: fibromyalgia; WPI: Widespread Pain Index; WS pain: widespread pain; SSS: Symptom Severity Scale.